1.Diagnosis and treatment of recurrent urethral stricture with false passage
Quanfu MA ; Xiangfu ZENG ; Yannian YUAN
Chinese Journal of Minimally Invasive Surgery 2001;0(05):-
Objective To evaluate diagnostic methods and long-term curative effects for recurrent urethral stricture with false passage. Methods Among a total of 620 cases of urethral stricture or atresia treated from March 1987 to March 2005 in this hospital,false passage was present in 40 cases(6.4%).Diagnostic methods included urethrography,sonourethrography,injection of methylene blue into the bladder by cystostomy,CT and/or MRI examinations,or exploration by vesicotomy.Surgical methods included insertion of a memory metallic stent after urethrotomy in 10 cases,electrotomy in 7 cases,urethral reunion in 4 cases,hydroelectric shock wave therapy in 8,posterior pull-through urethroplasty in 4,patient self-administered urethral dilation in 5,excision of false passage in 1,and perineourethrostomy in 1.Results All the 40 cases were followed for 1~15 years(mean,9 years).The urethral stricture was cured in 32 cases(80.0%),and therapeutic failure was observed in 8 cases(20.0%),including 4 cases of unstable pelvic fracture.Conclusions Sonourethrography is the most accurate noninvasive method of staging urethra strictures.It is simple to perform,requires no radiation,and offers a dynamic three dimensional measurement.
2.Influence of timing of intra aortic balloon counterpulsation on clinical efficacy in patients with severe heart disease after operation
Wei HUANG ; Guodong CHENG ; Chunlei ZHU ; Xiaofang LI ; Jinming ZHANG ; Quanfu YUAN
Clinical Medicine of China 2021;37(2):166-170
Objective:To investigate the effect of the timing of intra-aortic balloon counterpulsation (IABP) treatment on the clinical efficacy of patients after severe cardiac surgery.Methods:A prospective study was conducted on 64 patients with IABP after cardiac surgery in Gaozhou People′s Hospital of Guangdong Province from March 2018 to March 2020.According to the time of IABP treatment, 33 patients were divided into early treatment group (severe cardiac surgery<6 h) and late 31 cases in treatment group (≥6 h after severe cardiac surgery): two groups of mean arterial pressure(MAP), left ventricular ejection fraction (LVEF), mechanical ventilation time, IABP indwelling time, ICU stay time, central venous oxygen saturation(ScvO2), N terminal pro B type natriuretic peptide(NT-proBNP), lactate clearance rate, complications and follow-up.Results:After 48 hours of IABP, MAP and LVEF in the early treatment group were (79.47±7.07) mmHg and (45.20±3.86)%, respectively, and those in the late treatment group were (71.38±6.26) mmHg and (41.66±4.49)%.There were significant differences between the two groups ( t value was 34.604, 29.375 respectively all P<0.01). The mechanical ventilation time (71.56±5.98) h, IABP indwelling time (68.31±10.10) h, ICU stay time (5.84±1.04) d in the early treatment group, and those in the late treatment group (82.79±4.96) h, (89.49±9.97) h, (6.82±1.07) d. There were significant differences between the two groups ( t value was 70.093, 72.855, 31.859 respectively, all P<0.01). The ScvO 2, NT-pro BNP and lactate clearance rate in the early treatment group were (71.66±5.45)%, (1 698.36±1 032.98) ng/L and (30.12±2.29)%, respectively at 48 hours after IABP, and those in the late treatment group (66.03±4.61)%, (2 898.43±1 383.29) ng/L and (20.47±1.92)%.There were significant differences between the two groups ( t value was 38.279, 34.379 respectively, all P<0.01). The incidence of complications were 18% (6/33) and 41.94%(13/31) in the early treatment group and the late treatment group.There was significant difference between the two groups( P=0.038). Conclusion:Early use of IABP treatment can improve the patients′ hemodynamic and serological indicators, reduce the patient′s mechanical ventilation time, IABP time, ICU monitoring time and complications.
3.Development of a model for predicting success of trial of labor after cesarean delivery at term
Baoling LAI ; Quanfu ZHANG ; Hailing YUAN ; Li CHEN ; Shixin YUAN
Journal of Chinese Physician 2018;20(2):204-207
Objective To establish a suitable model for predicting the success of trial of labor after cesarean section (TOLAC) during the pregnancy at term.Methods Data for all deliveries at term with one cesarean delivery history in Shenzhen Maternity and Child healthcare hospital during 1 January 2012 to 31 December 2014 were reviewed.Variables associated with VBAC were identified and used to build a model to predict the outcome of TOLAC with multivariable logistic regression.Godness of fit and accuracy of the model were evaluated by ROC.Results A total of 531 women met inclusion criteria and underwent TOLAC.Of the women who underwent trial of labor, 448 (84.4%) had a successful VBAC, 83 failed, and 2 (0.38%) had uterine rupture.Multivariable logistic regression analysis showed that previous cesarean section (CS) time interval, neonatal birth weight (BW) and premature rupture of membranes (PROM) were independent factors affecting TOLAC outcome, and their Odds Ratios were 2.79, 1.002 and 0.244, respectively.The Logistic regression model was expressed as follows:P =1/[1 + exp (2.4 × neonatal BW + 1.03 × previous CS time interval-1.41 × PROM-10.24)].The Hosmer-lemeshow test showed that the model fitted well (x2 =123.45, P =0.996), and the prediction accuracy of the model was 86.77%.The model performed well with an AUC of 0.794 (P =0.000).Conclusions A predictive model, which contains three variables (previous CS time interval, neonatal BW and PROM), has been developed and its prediction efficiency and accuracy are satisfactory.The larger birth weight, the longer time interval from previous CS, and the absence of PROM are more likely to be failed in TOLAC.
4.Development and preliminary application of the information monitoring system for radiological protection
Xiao LUO ; Mengxue LI ; Chuanjian WANG ; Baojun QIAO ; Yu ZHAO ; Zaiyun ZHU ; Yuan LI ; Jun DENG ; Quanfu SUN
Chinese Journal of Radiological Medicine and Protection 2022;42(7):538-543
Objective:To develop an information system for testing radiological protection that can interface with National Radiation Health Information Platform/Medical Radiation Monitoring Subsystem and to improve the testing efficiency.Methods:Complying with the relevant national regulations and standards, the analysis was carried out of demand investigation and system modeling. An information system for testing radiological protection was established using B/S architecture, comprising three modules such as testing, audit and system management. The users at four levels were set of administrator, inspector, auditor and report issuer.Results:Based on test result, the developed information system has been shown to realize the informatization of the whole process from filling, auditing, issuing, issuing of the testing report to data uploading, with improved testing efficiency.Conclusions:The developed information system for testing radiological protection can improve the testing efficiency, and can be successfully interfaced with the National Radiation Health Information Platform/Medical Radiation Protection Monitoring Subsystem.
5.Three nuclear power plant accidents in history and related public books
Cuiping LEI ; Long YUAN ; Quanfu SUN
Chinese Journal of Radiological Health 2021;30(1):117-122
The peaceful use of nuclear energy has a history of nearly 80 years, and the development of nuclear energy in China has been actively and steadily promoted. Up to now, there have been three major nuclear power plant accidents in human history: Three Mile Island nuclear accident in the United States, Chernobyl nuclear accident in the former Soviet Union and Fukushima nuclear accident in Japan. However, the public in our country knows little about the three nuclear accidents. This paper introduces some books on the three nuclear accidents for the general public, which help the public understand the nuclear accidents from a non-professional point of view.
6.Psychological first aid during severe nuclear power plant accident
Huifang CHEN ; Quanfu SUN ; Long YUAN ; Ximing FU ; Cuiping LEI
Chinese Journal of Radiological Health 2021;30(1):48-52
The past three severe nuclear power plant accidents showed that the social psychological impact on the public is the most serious consequence of severe nuclear power plant accidents. When a severe nuclear power plant accident occurs, individuals / groups in the affected area may experience various stress reactions. Timely and effective psychological first-aid can help the victims to survive the crisis effectively and actively respond to the current life. Referring to the World Health Organization guide psychological first aid: guide for field workerand other national guidance, this paper introduces how emergency rescue personnel carry out emergency psychological assistance in case of severe nuclear accident.